Retinopathy in premature infants

According to the Centers for Disease Control and Prevention (CDC), about 500,000 babies are born prematurely each year. Of these tiny patients, about half will be diagnosed with retinopathy of prematurity, or ROP. In ROP, the blood vessels in the eye stop growing or they grow abnormally. ROP is staged from 1 to 5, with 5 being the most severe. In stage 5 ROP, the retina can actually detach and cause blindness. ROP can also cause bleeding in the eye (called vitreous hemorrhage), scarring, and cataracts.

Years ago, this condition was complicated and made worse by the use of high doses of oxygen required to support the lungs of premature babies. Today, advances in treatment have progressed. Oxygen administration is now more controlled, but ROP still is one of the primary concerns in premature birth. Generally, though, the earlier a baby is born, the more severe the baby’s ROP might be. The good news is, many babies with ROP will eventually improve.

Of babies with ROP, approximately 10 percent will need medical intervention. Currently, the Food and Drug Administration (FDA) has not approved any medications for the treatment of ROP, however, in some cases, a drug called Avastin® is being used. Typically, cryotherapy (freezing) or laser therapy are used to treat ROP. Both of these procedures aim to slow or reverse ROP’s damage. Unfortunately, neither laser nor cryotherapy work in every baby. For babies that don’t respond to laser surgery or cryotherapy, surgery may be needed to prevent blindness.

Many children with ROP will improve greatly by the time they are 6 months old but frequent follow-up throughout infancy and childhood is extremely important A pediatric ophthalmologist or a retina specialist are the two types of eye doctors most comfortable with following and treating ROP. Children with ROP in infancy may later have vision problems, including amblyopia (sometimes referred to as a lazy eye), nearsightedness, and glaucoma, which is why follow-up is so important.

Reviewed by Dr. Sara Connolly, December 2018